12 Days Post-op!

I meant to update this blog more while I was in the initial throes of recovery, but of course that's not the most feasible idea. As of this afternoon, I am 12 days post-op from metoidioplasty! I had my first post-operative appointment this morning with Dr. Hadj-Moussa which went very well. I'll get back to that - first I'll do a little recap of the past week. My last post went through to Day 3 post-op, so let's see what I can remember from Day 4 onwards.

A few days after surgery, I was still having a hard time sleeping comfortably. I'm not much of a back sleeper and sleeping on my side was out of the question, so that was a little rough. I was also having a little heartburn/mild chest pain from laying flat, so had to prop myself up on a bunch of pillows. That was just generally uncomfortable, and I was still in enough pain that it was difficult to move around too much. Days 4-6 were the worst of the bruising, and woof. It was rough! I was telling all of my friends that I had the bluest balls in the Midwest (truly could have been the case). It was somewhat painful, but still manageable with Tylenol and Ibuprofen. I was also taking the bladder spasm meds (Phenazopyridine) consistently three times per day. My bladder spasms weren't too bad, but they were present, especially anytime I sat on the toilet to poop. I was drinking a big cup of Miralax mixture every morning to keep my stool soft, and that has worked well for me. 

A note about bladder spasms: I really didn't know what to expect until I experienced them. I've seen people talking about bladder spasms related to catheters plenty, but never really grasped what the symptoms looked like until it happened. My first experience happened pretty much right when I woke up from surgery, with the sensation that my bladder was really full and I had to pee. That evening I started having a tensing/twitching sensation that felt like it started in my bladder and went all the way through my new urethra/dick. That didn't necessarily hurt, but it was really uncomfortable and felt like a lot of stress on my new urethra. Those sensations subsided once I started taking the bladder spasm meds, except for after I poop. It's like my body is used to relaxing all of those muscles at once, so after I have a bowel movement I still get that twinge through my urethra, and my whole dick twitches. I've talked to someone else who has that same sensation so I don't think it's uncommon, but it's not necessarily what I expected! The twitching has gotten less intense at this point, which is nice but also worries me a little bit because in the back of my head I'm concerned that my bladder spasm disconnected my new urethra from my natal urethra. That could be totally unfounded, but I won't know anything until I have my voiding trial in mid-December - so for now I'm trying to stay calm and let go of what I can't control!

Everyday was consistently a little better for the most part, particularly around bruising and swelling. I've consistently had some drainage/light bleeding, mostly at night. In the earlier days it was enough that I would wake up to a pink/red spot underneath me, but at this point it's lessened so that I just wake up with dried blood on my butt cheeks. Not the most comfortable feeling lmao but I'm hoping it continues to get better. I've been showering everyday and then changing the gauze sponge after the shower. Showering was definitely a highlight of my days - it's so nice smelling good and feeling clean when I pretty much just sit around all day. I was able to walk around the AirBnB more and more throughout the day, and have had a consistently easier time sitting/standing and moving around. I found that it was actually a lot easier to get in a comfortable position than it was after top surgery because I have full use of my arms and my mons resection scar is low enough that it doesn't have much impact on my abdominal muscles. 

I didn't put pants/underwear on until Friday, November 26th: Day 9 Post-op. It is WAY more comfortable to be naked than to have anything touching my junk in it's sensitive/swollen state. I made a big foray to the Starbucks drive-thru (partner drove of course) and walked around CVS a little bit, and it was honestly exhausting. Since I had the issue with passing out after surgery I feel a lot of anxiety around the possibility of passing out again, and get nervous about being out and about without knowing if there's a place I can sit down. It was still really nice to leave the house and get some fresh air, but I was pretty beat afterwards. The day after that we went to Culver's for custard, and then on Sunday we went to the grocery store and I realllllly got to walk around. I was fine for the most part until the end when I started to feel tired/not as grounded and had to sit down in the bagging area of the self check out lol. But I made it! And then I made it to the car and it was all fine. I think a lot of it is anxiety, which comes from a reasonable place. Baby steps.

So! Today is November 29th: Day 12 Post-op. (Weight loss mention later in this paragraph) I had my first post-op appointment today and it went really well. I arrived to the clinic at 10:30 and got called back immediately after arriving. The nurse took my vitals and checked my history - I've lost a few pounds since surgery which is normal for me but it's a wake up call that I need to keep up my protein intake and try to eat more. I think the bladder spasm meds mess with my appetite a little bit and I'm not burning many calories while I'm recovering, so I'm trying to eat well but it's tough! I hope I can gain that weight back as I recover. 

After a few minutes in the exam room Dr. Hadj-Moussa came in (I think she arrived before my actual appointment time of 10:50, which is always wildly impressive to me). She jumped in asking me how I've been feeling, how recovery is going. I told her I've only been using Tylenol since I left the hospital and she was shocked - I assured her that I'm no martyr and would've taken the meds if I was hurting that much, and that I was as surprised as she was that I didn't feel like I needed them. I don't feel like I have a wildly higher pain tolerance than other people - I think I also had pretty ideal conditions for recovery, have a lot of confidence in my body's ability to heal, and respond well to Tylenol and Ibuprofen. I also drank a ton of fluids the first week after surgery and used ice (frozen peas, really) liberally. 

After we chatted for a few minutes she had me get on the exam table and take my pants off so she could take a look. She gloved up and moved things around a little bit but all in all was looking at my genitals for maybe 20 seconds. Dr. HM is very confident in a way that I find really reassuring - she's concise and clearly knows what she's doing. She said, "You're an impressive healer, my friend!" which felt like a major compliment coming from her. I got the sense that she felt proud of the work she did, which I really hope she feels! I also feel proud of her work, lol. I had her take a look at my suprapubic tube site because it was looking a little pink/oozy after my shower yesterday and she said it looked totally fine (I think it was just a scab that had gotten soft during the shower). I pulled my pants up and she talked to me a little bit more about getting a leg bag for my catheter and what to expect for the second post-op appointment, and then she was off! The nurse came back with all the supplies I will need for the next few weeks - three leg bags (one for each week), a few more leg straps for the catheter tubing, and a bunch of alcohol swabs for when I change the bags. I'm supposed to put the big bag back on every night for safer drainage.

And today my partner and I did a bunch of packing and cleaning! Tomorrow morning we head out of our AirBnB and are driving several hours to my parents' home, where I'll be staying for the next few weeks. It feels like a good time for a change, and this was a really special time here with my partner. I'm eternally grateful for all of her support, cooking, cleaning, holding my catheter bag while I shower, love, comfort, all of it. More later!